Preventing multiple diseases by tackling dangerous insects

Vector Control Tackling malaria does more than save people from one disease. Killing bugs protects against multiple diseases and greatly improves maternal and neonatal health.

Richard Allan

Director, The Mentor Initiative

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Organisations involved in the fight against malaria need to change their messaging to encompass the multiple benefits of fighting insect-borne diseases, in addition to malaria, as well as the vast health improvements offered to mothers and young children.

It is important that they do so because it cannot be automatically assumed that funding for the fight against malaria will carry on at current levels and yet campaigners battling against the deadly disease face some very testing challenges.

The most serious is the growing level of resistance among mosquitos and parasites to insecticides and medicines. It means new tools, drugs and techniques have to be developed to carry on today’s momentum in to the future. At the same time, extending the good work being carried out in many areas across Africa in to the remote sub-Saharan regions is a huge task that will require major new programmes to be funded.

However, just as this extra push is required to carry on encouraging early momentum, the public’s attention seems to be shifting towards neonatal care. Hence, organisations need to concentrate on getting over a message that when you tackle malaria there are multiple knock-on benefits, particularly in protecting the health of mothers and their babies.

That is the conclusion of Richard Allan, founder of the Mentor Initiative which is the only organisation of its kind to have people on the ground in multiple conflict and disaster areas. It specialises in fighting malaria, as well as other insect-borne diseases, at the same time as training other aid agencies and local health care professionals in dealing with malaria. The aim is to provide help when it is needed during conflict or a natural disaster for as long as it takes until it is, hopefully, no longer needed.

“Malaria campaigners really need to get over the more bang for your buck message,” he says.

“When we spray insecticides that kill mosquitos and provide wall linings and strong insecticide-treated nets, we’re not only killing mosquitos effectively, we’re also taking out other insects, such as sand flies. It means we’re preventing several diseases, not just malaria. When you kill mosquitos properly you can also tackle dengue fever and elephantitis, with spraying and tighter meshing on nets, you help avoid awful conditions like leishmaniasis.”

Neonatal Benefits

So, Allan thinks that malaria organisations may have missed a trick in concentrating on a message around one condition when so many disfiguring and fatal diseases can be prevented at the same time as malaria.

Also, he has a feeling that as attention has shifted partly from malaria to the health of mother and new-borns, organisations in the battle against malaria need to refine their message to align themselves with the shift in public thinking. The person in the street may not realise that the best way of supporting mothers and babies is preventing them from getting malaria or treating them for the condition.

“Governments and the public only have a certain amount of time before their attention shifts, and that’s completely understandable,” says Allan.

“If you look at Comic Relief and many aid organisations’ literature and web sites now, the real interest seems to have shifted slightly to include pre- and post-natal care of mothers and their children. Again, this is an area where organisations involved in preventing and treating malaria need to be on the front foot.

“In areas where malaria is present, it’s the biggest cause of neonatal deaths and spontaneous miscarriage. If women contract malaria while they’re pregnant their babies will be lower weight because the parasites often go in to the placenta where they compete with the foetus for food and so that has huge health implications for a new born.”

The Missing Third

So, as attention shifts, organisations involved in the fight against malaria need to get more vocal about the knock-on effects of killing dangerous bugs and improving neonatal care.

In fact, the Mentor Initiative also hopes to have some new technology to start talking about later in the year. With support from Comic Relief it is testing new prevention tools, including insecticide treated wall linings, that use a new combination of insecticides, and against which malaria mosquitos have no resistance. Allan hopes to have positive results when a full scale Phase 111 trial reports its final findings in October. If successful, the wall linings will provide a long term malaria prevention solution for many communities.

They have also successfully tested the first mosquito nets designed specifically for people who sleep outside. They are designed for the third of Africa’s sub-Saharan population who are nomadic pastoralists and so sleep outside with their cattle. These are the forgotten people who standard nets have not been able to protect, because they cannot withstand the sun or rough outdoor conditions. These new “Demuria” outdoor nets have proven highly effective and can withstand the extreme conditions for almost two years. They have proven to be immensely popular with the many families that now rely upon them for protection.

“We believe it’s going to be revolutionary in fighting malaria because people tend to forget that a third of the people in sub-Saharan Africa sleep outside and so a regular mosquito net can’t be used,” Allan says.

“We’ve had to make a net that is very hard-wearing that can survive being packed away each day and carted around until the next night. Traditional nets just wouldn’t last and so we haven’t been able to tackle malaria among huge swathes of the country. We think the Demuria net we’re testing will change that for the first time.”

Allan is hopeful that when current trials are reported on in October, the news will be very positive and that campaigners will have their first effective tool to take the fight against malaria in to remote areas where sleeping outside is the norm.